Ilana Stanger-Ross

While hanging around waiting for a baby to be born the other night, the proud grandfather told me the following story.

He and his wife (the mom of the labouring mom) had 12 children.

Together they’d attended prenatal classes when she was pregnant with their first, studiously memorizing the normal labour pattern: mild, infrequent contractions building in intensity, length, and frequency until the start of active labour, when the cervix dilates from 3-4cm to 10cm, at a rate of about 1cm per hour.

Well. She had a mild contraction. He noted it. 10 minutes later, she had a second. Five minutes later, a third. One minute later, a fourth.

They got in the car.

The baby was born minutes after they arrived at the hospital.

Their second baby was born en-route to the hospital.

With their third, she awoke in the middle of the night, had one contraction, and pushed out a baby.

“Which brings us to number 10,” the granddad told me.

By that time he’d already caught 5 of his children, but it was never the plan. So when his wife felt like baby #10 was on the way, they headed over to the hospital and went straight to L&D admitting.

“When did contractions begin?” the charge nurse asked.

“Oh,” said his wife, “they haven’t.”

“You’ve had no contractions?”

His wife explained that this was baby #10, and that she felt like it was going to be born that day, “probably within the hour.”

The charge nurse refused admittance, citing, reasonably enough, the complete & total lack of labour.

So, they drove back home.

On the way the dad called their doctor. “If you want to deliver this baby,” he said, “you’d better come over right away.”

As it turned out, the doctor was the charge nurse’s brother-in-law. After stopping by the house to give the once-over to the now breastfeeding newborn, the doctor tucked the placenta into a garbage bag and hightailed it to the hospital.

He then left the garbage bag on his sister-in-law’s desk.

How’s that for a birth story?

It’s been quiet here. Eerily quiet. We’re talking browsing strip-malls/getting up-to-date on Jon & Kate/trusting that there’s something I’m learning in exchange for being in Northern Alberta far from my family with no births/ quiet.

Quiet enough that I watched The Proposal at the West Edmonton Mall. A famous (infamous?) mall which has a pirate ship, submarines, sea lions, an amusement park, a casino, and a hotel. 

Did I mention the submarines?

The Proposal was entertaining in a pre-feminist-movement kind of way, especially since it gave me insight into the life of my book editor.

(”We’re dying to know–what does a book editor do?” two fawning guests ask at the mock-engagement party. Hmmm. Wouldn’t it be relatively obvious what a book editor does?)

It has got me thinking, however, about career. Every job has its lines, the things we say over and over. Like “Please take a number” or “We take visa or mastercard” or “Use APA formatting next time.”

This is what I say, over and over:

“Okay, now bring your ankles together and let your knees fall to the side. That’s right. Now you’re going to feel my touch, and some coolness from the gel, and then a bit of downward pressure–”

It’s an odd job.

In my first year at UBC I read I knew a Woman , an account of the caregiver-patient relationship by Courtney Davis, a nurse practitioner in a women’s health clinic in Connecticut. At one point in the book Davis’s friend is marveling that she performs pelvic exams routinely, “touching women like it’s nothing.”

“Not like it’s nothing,” Davis replies.

In my 2nd year at UBC, we attended a pelvic-exam workshop where a group of incredible women taught us how to perform pelvic exams and paps.

On them.

The women knew their bodies, told us where we’d find their cervixes. They handed us mirrors and pointed out features of their anatomy. They breathed a sigh of relief we were midwifery students –”the medical students, they shake so much the speculums hum”–but were fast to reprimand us if our touch was anything less than gentle.

At the time, I compared it to Halloween as a kid at school: the mystery bags you were made to plunge your hand into while blindfolded, told it was filled with eyeballs. Without vision you had to rely on touch, using your fingers to see, processing through touch until you thought: peeled grapes.

It’s the same with a vaginal exam. Using two fingertips we feel and try to interpret: Where is the cervix and how open and how thin? How low is the baby, and in what position? Do we feel the amntiotic sac? The fetal head? The posterior or the anterior fontanelle?

I try to remember what Davis wrote, and so while pelvic examinations have become routine for me (though I’m no expert on navigating a baby’s exact GIS location from a suture line), I try to remind myself they’re not routine for the woman.

And more than that: given the stats on sexual assualt in our society, it’s very possible that the woman lying before me has been touched in terrible ways in the past.  I can’t control that, but I can ensure that my touch is thoughtful, deliberate, gentle. Like our teachers say: sensitive & skilled.

Some days I feel like I’m there.

Other days…

Midwifery is a profession where one grows & learns over a lifetime. Those are the lucky professions. But as an adult learner, it can be tough to feel that distance between theoretical knowledge & actual practice skill.

Yesterday I palpated my first breech. I called an experienced midwife over, not yet confident enough to declare the baby breech on my own. She felt the mother’s belly and couldn’t be sure, so we used ultrasound (the midwives here have ultrasound) to confirm the presentation.

Yup, breech.

“That’s my first breech palpation!” I exclaimed. And then remembered the mother on the examining table, the anxiety on her face as she worried over whether her operating room date was about to be booked.

(I’m not a total lout–she was only 33 weeks and a 3rd time mom, which, I quickly assured her, means plenty of time & space for the baby to turn. And: The SOGC [Canada's ACOG] has recently called for a return to vaginal breech birth.)

Of course, touch isn’t only about assessment. As midwives we also wipe foreheads & rub backs, bend to help a woman slip on her socks, stand tall to wrap a warm blanket around wet shoulders.  

A friend in Edmonton referred to herself as a “doomer.” As in: doomsdayer. I’d never heard the term before, but told her that, since we’d been on the subject, the approaching apocolypse was a reason to like midwifery. While in our current practices we depend on all sorts of technological bells & whistles –from ultrasound to functional ORs–midwifery at its heart is about respecting –even guarding–a natural process and assisting it with touch, words, support.

The Doomer is a Nephrologist.  “Take away my machines,” she said, “and I couldn’t do anything. Anything.”

But sometimes, touch is one of the most important things we can offer.

When I worked at a women’s clinic I followed the nurse’s lead by taking a woman’s hand in my own as an abortion began.

“Squeeze as hard as you want,” I’d tell them, “it won’t hurt me.”

There was one woman whose hand I was reluctant to take–she was so gathered into herself, I didn’t want to violate her privacy. At the same time, I had found that asking only made it difficult for women to say, yes. Better to take her hand, I decided, and judge from her hold whether she needed someone to hang on to or not.

She gripped my hand back. And said to me afterwards: “I was so hoping someone would hold my hand.”

What did this have to do with The Proposal? I can’t remember. I’m just biding my time here, learning from some very wise midwives, hanging around pregnant mothers, occassionally practice-suturing placentas (okay, once, but that’s one date I plan to repeat) and trying to remember as I wait for births to forget about the numbers (we students need to count them, and it can be hard to silence that count) and remember instead that 4 births = Grace, Lucy, Caitlyn, & Evander.

And it’s the stories behind those numbers that make the caregiver.

There are several UBC Midwifery students on far-flung adventures this summer, and their blogs are absolutely riveting to read. You can hear from the students in Uganda here and The Netherlands (departure quickly forthcoming) here.

Meantime, I’m continuing to adjust to Alberta. After the rush of the first day it’s been quiet, and I’ve had a lot of time on my hands. So: I’ve gone for 2 runs. (And in doing so discovered horses & donkeys three blocks away, where the edge of town gives way to fields. “It’s like a kibbutz,” I told Jordan. Pretty sure I am the first visitor to compare Stony Plain, AB to a kibbutz, but there you go.)

I’ve also begun researching for my midwifery thesis paper (actually, I find it appalling that in addition to full-time clinical work & weekly research assignments a thesis is also expected. Far be it from me to normally whine about writing & research, because I tend to get all nerdy-excited about such stuff, but WHINE) and working on developing pharmocology note cards–something that’s been on my to-do list since February.

And the next novel. Starting to think through that.

Which somehow all still leaves time to relax with wine in the back yard after dinner, talking till late because the sun stays in the sky so long it’s easy to lose track of time.

This is what happens when you leave your kids behind. The days grow looooong.

Long enough too to worry that I misled y’all with my multip vs primip comments the other day. See, here’s how it works:

Gravida = Number of pregnancies

Para= Number of births after 20 weeks

So a woman might be G4P2, which means she’s had four pregnancies and two births.

A more detailed description might be G4T1P1A1L2, which means 4 pregnancies, 1 Term birth, 1 Preterm birth, 1 Abortion (spontaneous or terminated–there’s no clear distinction drawn), and 2 living children.

So back to this gravida/para thing.

A Primigravida does mean first pregnancy. But Primiparous actually means one birth. See the difference?

So we say “primip” for first-time moms, but really it should be “primig.” Or Nullip, for nulliparous. Other than that, you can say multiparous or multigravida, Grand Multipara or Grand Multigravida. It starts sounding like a Starbucks drink, doesn’t it?

“I’ll have an iced Grand Multipara with caramel, please.”

 Meantime: got paged today while on a run. (Not the horse/donkey run, the other run). A woman had come in hoping for an induction. Only she didn’t have any medical indictation for an induction, she just was sick & tired of being pregnant.

There’s a distinction drawn between medical inductions (for a clinical reason) and social inductions (no clinical indictation), and this one would be termed social.

And in Canada, we don’t do social. Or at least otuside the major urban centres. Or at least with midwives. Or–you get the idea.

(Far as I can tell, in the US a woman can have an induction anytime she wants for any purpose. And if she doesn’t want one, she’s likely to get one anyway. But I digress.)

I examined her and broke the news, and she was not pleased. But I also gave her verbena, an essential oil from Germany that has long been used to hasten labour but has never been studied in a clinical trial. Okay, so a typical midwifery move, albeit not one I’d ever done before.  What was interesting here, however, was that the nurses guard the verbena at the hospital, and keep along with it a recipe for the verbena cocktail (almond butter & apricot juice….not for the weak of stomach) and a form to fill out if she goes into labour, so that data can be collected.

In the hospital.

In the maternity ward.

Astounding.

I’ll let you know if it works.

So….

At 5:30 am yesterday morning I kissed Jordan goodbye, gave one last, long look at my sleeping daughters, and took off for the airport. Destination: Edmonton, Alberta. Within a few hours I was at a friend’s place, and then driving another friend’s truck through the outskirts of Edmonton, on my way to Stony Plain, where a legendary birth centre has been attracting BC student midwives for years.

Sometimes a voice in my head says something along the lines of: “How did a kid from Brooklyn end up here?”

Driving an unknown truck — did I mention the cracked windshield, apparently de rigour for Northern Canada?— through an unknown city was one of those moments.

But then: I pressed ‘play’ on a mystery tape in the tape-player, and at once was comforted by the reassuring lyrics of Uncle John’s Band–a song I haven’t heard in years but apparently still know by heart:

Oh, the first days are the hardest days don’t you worry anymore

‘Cause when life feels like easy street there is danger at your door….

And so I arrived in Stony Plain.

I’m staying with one of the midwives here, and came prepared with 3 bottles of wine–midwives are notorious lushes when we’re off-call, after all. I got a big hug for the gift, and an invite to a fabulous family dinner. Two other student midwives–Roz and Gillian– joined me, and we talked NSVDS –normal spontaneous vaginal deliveries, as if it isn’t obvious–to our heart’s content.

The first page came at 5:30 the next morning.

There must be something in the water here, because when I left the birth centre 12 hours later I’d witnessed not one but three NSVDs. The first I simply observed. Another student, Roz, motioned me in, telling me the baby was on its way. 

Impossible, I thought, entering the room. That woman still has her underwear on.

Well, she got it off. And the baby came 3 minutes later.

I then returned to ”my” labouring woman, who spent the next several hours swapping stories and laughing, only occassionally pausing to gaze somewhat distractedly off into the distance.  If you’d asked me to guess her progress based on her demeanor, I would’ve said 2 cm dilated, early labour, go back to sleep. But I knew from examining her that was 9cm dilated, with a history of laughing her babies out. Eventually she birthed a beautiful boy in the birthing tub –such a simple thing, a tub, and such incredible pain relief, yet so many hospitals, mine included, don’t have them for labouring women–her husband catching while I coached him through it.

(”How do you coach a husband through it?” I’d asked Roz earlier. I’d never done it before, and wasn’t sure when to step back. In the end it was easy, because he was a natural. But I did provide one key interference: his wife was on all fours, and I had to guide his hands not back –it’s an instinct, to bring the baby towards you–but under and up to where the woman herself  can reach down and take hold. Because otherwise you have a woman on all fours with a newborn wailing from behind her bum. Which isn’t what she wants, trust me.)

And then those adorable, laughing, story-tellers –well, they wept. Which is always the best part.

The last birth was a doozy, and make note that this is the first time I’ve used the word “doozy.”  With every room filled, a client (or as we say, a “multip”***)   arrived with fluid leaking. She was Group B Strep positive, which to make a long story short means IV antibiotics. So I inserted the IV on the couch in the hallway, then brought her into an assessment room while we waited for housekeeping to clean out a Labour & Delivery room.

“My water broke an hour ago and I’m just starting to get contractions,” she told me. “Watch me be, like, 1 cm dilated.”

Well, she was 8 cm dilated. 

Do you see what I’m saying about the water?

20 minutes later she reported pressure with contractions. I checked her again: fully dilated with a bulging bag of waters. I ruptured her membranes, which soaked my arm, and so turned around to wash up. When I turned back around she was crowning. Roz was ready & gloved, but technically off-call. Not one to give up a catch, I cracked open a new pair of sterile gloves and caught her baby 2 minutes later.

9 lbs.

Well, that’s been my welcome to Alberta. And now: to sleep and shower.

*** multip = multiparous = previous delivery; primiparous =first time mom. Except actually these terms are misused, because techincally nulliparous =first time, primiparous =2nd time, and multiparous connotes 3rd and up to 5th, at which point you’re a Grand Multipara.

How’s that for a prestigious title?

I scrubbed in on a day of gynecological surgery. Or as they say in the biz, “Guy-knee.” Which was awesome. Truly awe-some: I had no idea intenstines were so beautiful. And don’t get me even started on the fimbriae , who hang out like sea-creatures, translucent tentacles gently waving as they await their chance to catch the egg and pass it to the fallopian tube.

“If I could be any body part,” the Ob/Gyn told me, “I’d be a fimbria.”

I could see his point. And might agree, were it not for that dusty rose uterus, so smooth and neat and palm-able, all the more amazing to contemplate how it grows to grow a baby.

Imagine being handed a ziploc bag, and then told to use it to carry a watermelon. It’s kind of like that.

My lord but the body is astounding.

And the OR is kind of astounding, too. I love the pomp & circumstance of it (the nurses asked me my glove size! I got to do that sterile-gown twirl that surgeons do!), although at times that same pomp & circumstance has had me cowering in a corner, afraid to do anything wrong lest I inherit the wrath of the scrub nurse. But usually we student-midwives have nothing to do in the OR but observe (say during a client’s c-section) whereas here a generous Ob/Gyn had invited me to participate. I did small tasks: snipping sutures, injecting local anasthetic, and of course inserting all manner of things into the vagina (speculum & IUD are practically old-hat by now, but video camera was a first). But mostly I watched in complete amazement.

Feeling out of shape for summer? Go take a look at  an appendix.  See how beautiful you are!

Yikes–nearly a week has passed and I have yet to blog about The Big Night. So: there I was, one of about 50 Jewish Book Network authors to present my pitch in the 1st of 3 nights of pitches.  We were  ushered into a room (actually a sanctuary) where one after the other in alphabetical order we each proceeded to give our 2 minute shpiel. It was extremely intense, running like clockwork: I never saw a Jewish event proceed on-time like that. By the time they got to “S” I was a wreck: authors whose NY Times book reviews I’d read had presented; authors with careers involving David Letterman and selling pre-emptive movie rights had presented. What did I have to offer?

Well, I got up and did it and only stumbled once. And did a good enough job that someone (Austin? DC?) later came up to me and said, “There you are, we’ve been saying we had to find the bubbly-blonde.”

I’ve never been called a bubbly-blonde before. LOVED it.

So then after all that pitching, we were ushered into a basement dining hall where they served us beige food and gave us absolutely no alcohol. Nothing. I have never wanted a drink so badly in my life. Especially as we writers kept being urged to circulate, and the pressure was keen to meet & greet & impress, over and over again.

And yet: I got to speak with some lovely women, all of whom were there because they loved books and loved their communities and wanted to bring Jewish writers to Jewish readers– a noble cause, to my mind, and one I am of course hankering to help out with.

And: there were NY black & white cookies. Albeit the mini-kind.

And: I met Palm Beach, who loved, loved, loved Sima and hopes, she told me, to team up with Miami and Ft. Lauderdale to bring me over.  Which sounded pretty amazing to me, especially since more than one rep had told me that coming from Victoria I was a bit hard to budget for, flight-wise.

(Damn that Canadian border. The flight from Victoria to Seattle takes less than 1/2 hr but bumps up the ticket price by at least $200. Grr.)

Anyway, fingers crossed that someone will find me worthy of breaking the bank.

Well, I’m back in the Big City for the 3rd time since February, albeit for a very, very brief stay. Arrived 5:30 pm this Saturday evening and depart with the dawn on Monday. But tomorrow: tomorrow I have a full-day of literary….ummm….literary stuff. Brunch with my agent & editor –how much do I love that sentence? — and then a pedicure (okay, not so literary, but it leads into the next item) followed by my 2 minute book-shpiel + shmoozy dinner with the Jewish Book Network.

But before I go into that: can I talk about the flight? I was utterly sans children.  No need to entertain anyone during the customs line; no need to talk to anyone at all. All I had to do was sit still for 5 hours. I read a book. An entire book. And I slept. And I ate fine, because there was actually room in my solely carry-on luggage for my food. And…

Okay, I can tell, you’re bored. But as Jordan put it: traveling with or without one’s children might be one of the greatest discrepencies in the parent-game. And just this once, the without felt nearly luxurious.

Now–Vancouver. I had a reading last night at Diane’s Lingerie. Despite the fact that I showed up 10 minutes late due to a delayed bus at the ferry terminal(cut to image of me hustling down Granville, my rolling luggage banging along beside me), it went really well. 

(I know, I know: I should have taken a cab. But perversely, the longer I sat on the bus waiting it to depart the ferry terminal the more committed I became to staying on it….)

There was a  good mix of pregnant ladies & student midwives, for one. There were also women from a Lilith Magazine Salon, along with my personal publicity heroine, Rebecca Wigod of The Vancouver Sun. Wigod’s incredibly generous profile/review of me ran all over Canada, an act of good-will outdone only be a personal call I later received from her mother, who not only told me she loved my novel, but described exactly what I’d always hoped readers might love about it.

Meantime: it’s past midnight in NYC but I’m staying up to greet my parents, who went out to a Broadway Show this evening and got caught in Obama & Michelle-mania. Once again they’re outdoing me with their social life. But no matter–I have that brunch date tomorrow morning. With my editor & agent–or did I already mention that?

I’ll blurt out the big news first: Penguin has bought Sima’s paperback rights!

It’s good. Really good. It means a whole new “package,” apparently: another cover, another launch, another chance. 

Very, very exciting. Even though I love the old cover & even though I have become a huge fan of Overlook Press, still, this is clearly a very good thing. June 2010: a summer read. I have to say, when I was writing Sima  I never really envisioned it on a beach blanket. But apparently it’ll be marketed that way.

It must be all those boobs.

Meantime: things continue on here, the daily routines similar each day while, at the same time, the girls change constantly. It’s an interesting contradiction. In the last few weeks Eva’s favorite colour went from pink to purple to pink again, plus white. Horses are out; dogs and cats are in.  She dresses herself easily, and has even started dressing Tillie–or rather, suggesting ensemble combinations which Tillie, unbelievably opinionated & strong-willed, mostly rejects, inevitably selecting something from Eva’s closet instead.

So Tillie trips along in size 4 dresses and Eva looks out for her. This weekend I watched in amazement as Eva carefully helped Tillie climb rocks, one arm protectively around Tillie’s back. They are both big into rocks, and right now Victoria’s best rock-spots are dotted with amazing blue wildflowers, an incredible setting which gives Tillie’s drowning-dress-look a very pleasing Little House on the Prairie aesthetic.

Another first this weekend: we had the kind of dinner party we all remember our parents having. You know, where the children amuse themselves in one room and the adults in another. As opposed to the kids being the entire focus. Don’t get me wrong: I like focusing on my kids. But my generation takes it too far sometimes. We’re so serious, so concerned, so protective…the other day I listened to Tillie crying out for freedom from the constrains of her car seat: “Up Mommy now! Up Mommy now!” and thought that when I was her age, if I were bored in the car I’d, well, go for a walk. I’d climb over the back seat, hang out in the “backity-back” –station wagons basically had playrooms–or crouch down in that soft spot behind the seats. 

My father thinks the car seat is basically my invention –he’s chided me more than once for my “obsession” with car seats. “Admit it,” he’s told me, watching me strap in the girls for what he’d consider a short enough ride to not warrant seat belts, “everyone has their shtick, and this is yours.”

I’ve tried explaining that the car seat isn’t my shtick–it’s a law. And sure we’re all in favour of making the roads safer for our children. But our kids have lost some freedom, too. So Saturday night we toasted to the Penguin deal out on the deck while a roving band of kids made a mess of the basement. Aahh. New starts, and a revival, too.

Weeks past the deadline, I’m trying to sum-up Sima in a 2-minute blurb that I’ll read in front of umpteen Jews for the Jewish Book Network audition. Prove you –and your book–are appealing & nail down the Jewish content requirement, and you could be whisked away on an all-paid, cross-country tour of Jewish Book Fairs, synagogue readings, and JCC appearances.

“It made Jonathan Safran Foer ,” I was told.

Which is maybe a bit of an exaggeration, since as I recall Safran Foer debuted on the cover of the NY Times Book Review. Still: an amazing program and an amazing opportunity: the chance to get my novel into the hands of readers across the country.

So here I am, trying to balance personal appeal, story interest, and Jewness into a 2-minute package.

The trouble of course: if they do choose me, how the hell will I get the time off clinical placement?  And why does it feel so much like being pulled in different directions? And why does it feel so much like guilt? (Am I abandoning my book? Shirking my clinical training? And don’t get me started on my family…)

One step at a time. I had to audition–I just couldn’t not try for it– even though it means flying to NYC on Saturday and returning on Monday in time to start my next placement.  The good news is that if I lose I win– if no one wants me, no conflict arises. And if I win I win, too, because then my book gets more than life-support — a new jolt, defib!

(No: that’s not my midwifery-training talking, just the late nights watching Gray’s Anatomy.)

2 minutes. 2 minutes. Breasts, breasts, Jews, Jews, Mother, daughter. Anything else you think I should include?

My double-life continues. On Monday I began my first of three summer placements, with a fabulous health clinic. The usual first day stuff: feeling incompetent, trying to cover feelings of incompetence and so fool everyone else into thinking I am competent, yada yada. Small successes: the metal speculum is feeling friendlier, and I may just have run out of ways to be creative in failing with IV starts, which makes me thing I’ll begin succeeding with them instead.

Left clinic exhausted, and after a solo dinner of Roti (Jordan & the girls were on Pender Island with friends, which means no one feeds me, but I do get to eat all the things I love that he hates) went to a former client’s book club.

It was at a new restaurant in Victoria. And I love a new restaurant in Victoria. Lucy’s in the Square, in Fernwood: you heard it here first. And while I’m blogging about new restaurants in Victoria, also check out Devour downtown, with chef Alison Biggs–she provided fantastic food at my Victoria launch, and her new spot is getting rave reviews.

Mmmmmm.

Where was I? Oh yes: a book club, with wine & cheese & all things delicious. And a few hilarious women, and a baby whose birth I was lucky enough to catch. (He was looking delicious, too.) And interesting questions about my book.

The perfect way to end a day chock full of those first-day-on-the-new-job jitters.

Except that of course they began again the next day. And continue. But someone once told me: it’s a marathon, not a sprint. I’m hoping it’s the same with Sima, too, and for now am trying to stay in both races.